A Comparative Study On The Curative Effect Of Surgical Treatment,mild Hypothermia Treatment And Conservative Treatment On Severe Primary Brainstem Hemorrhage

Objective:To analysis the curative effect of surgical treatment,mild hypothermia treatment and conservative treatment in patients with severe primary brainstem hemorrhage.Methods:A total of 50 patients with severe primary brainstem hemorrhage admitted to the NICU of the First Affiliated Hospital of Shenzhen University,Shenzhen Second People’s Hospital from January 2016 to January 2022 were selected and divided into the surgical treatment group(15 cases),mild hypothermia treatment group(13 cases),conservative treatment group(22 cases).The 30-day mortality,90-day mRS scores,changes in GCS score before and after treatment and the incidence of complications were compared among the three groups by collecting clinical baseline data and follow-up data at 30 and 90 days of treatment for all enrolled patients.Results:The general data(age,gender,history of hypertension,history of diabetes,smoking history,drinking history,brainstem hemorrhage volume on admission,GCS score on admission)of the three groups:P>0.05,with no significant difference.The patients’ 30-day mortality of the three groups:P=0.32,with no significant difference.The patients’ 90-day mRS scores of the three groups:P=0.326,with no significant difference.The change of the GCS score between the 30th day of onset and the day of admission in the three groups:P=0.005 in the surgical treatment group,and the difference was statistically significant;P=0.063 in the mild hypothermia treatment group,P=0.217 in the conservative treatment group,with no significant difference.Comparison of complications in the three groups:the incidence of intracranial infection in the surgical treatment group was higher than that in the other two groups,the difference was statistically significant(P=0.009);The incidence of hypoproteinemia in mild hypothermia group and conservative treatment group was higher than that in surgical treatment group,and the difference was statistically significant(P=0.01).Conclusion:For patients with severe primary brainstem hemorrhage,surgical treatment may be more beneficial for early improvement of clinical symptoms.However,surgical treatment,mild hypothermia and conservative treatment showed similar long-term efficacy in patients with severe primary brainstem hemorrhage.It is suggested that if the conditions of patients allow,medical units with mature surgical skills and good perioperative management may try to take surgical treatment.